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一名克罗恩病患者出现巨大的骶前脓肿。

Large presacral abscess in a patient with Crohn's disease.

作者信息

Wang Jing, Ng Matthew, Kochar Kunal

机构信息

Chicago Medical School, North Chicago, IL 60064, USA.

Division of Colorectal Surgery, John H. Stroger Jr. Hospital of Cook County, Chicago, IL 60612, USA.

出版信息

J Surg Case Rep. 2019 Nov 4;2019(11):rjz297. doi: 10.1093/jscr/rjz297. eCollection 2019 Nov.

DOI:10.1093/jscr/rjz297
PMID:31700604
原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC6827548/
Abstract

A presacral abscess with sacral osteomyelitis and gluteal abscesses is a very rare complication of Crohn's disease and is often clinically unsuspected or overlooked. We report a case of a 58-year-old male who presented for right hip pain after a fall. An abdominal and pelvic CT scan showed an atypical presacral abscess with a fistulizing tract extending through the sciatic notch and lateral to the gluteus medius and minimus muscles forming an intramuscular abscess. The endoscopic transanal approach was used to drain the presacral abscess. This method of drainage was successful and the patient had a favorable prognosis.

摘要

伴有骶骨骨髓炎和臀肌脓肿的骶前脓肿是克罗恩病非常罕见的并发症，临床上常常未被怀疑或被忽视。我们报告一例58岁男性，其在跌倒后出现右髋部疼痛。腹部和盆腔CT扫描显示一个非典型骶前脓肿，伴有一个瘘管，该瘘管穿过坐骨切迹并延伸至臀中肌和臀小肌外侧，形成一个肌内脓肿。采用内镜经肛门入路引流骶前脓肿。这种引流方法很成功，患者预后良好。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/8e45/6827548/0e34055bc499/rjz297f5.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/8e45/6827548/2f971e06c6ff/rjz297f1.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/8e45/6827548/b1d02955eb56/rjz297f2.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/8e45/6827548/247c597c5755/rjz297f3.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/8e45/6827548/e69618a8ad5a/rjz297f4.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/8e45/6827548/0e34055bc499/rjz297f5.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/8e45/6827548/2f971e06c6ff/rjz297f1.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/8e45/6827548/b1d02955eb56/rjz297f2.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/8e45/6827548/247c597c5755/rjz297f3.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/8e45/6827548/e69618a8ad5a/rjz297f4.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/8e45/6827548/0e34055bc499/rjz297f5.jpg

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本文引用的文献

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A novel approach for the treatment of pelvic abscess: transrectal endoscopic drainage facilitated by transanal endoscopic microsurgery access.经肛门内镜微创手术入路辅助经直肠内镜引流治疗盆腔脓肿的新方法。
Surg Endosc. 2012 Sep;26(9):2667-70. doi: 10.1007/s00464-012-2215-6. Epub 2012 Mar 10.
2
Management of abdominal and pelvic abscess in Crohn's disease.克罗恩病中腹部及盆腔脓肿的管理
World J Gastrointest Endosc. 2011 Nov 16;3(11):209-12. doi: 10.4253/wjge.v3.i11.209.
3
Comprehensive MRI diagnosis of sacral osteomyelitis and multiple muscle abscesses as a rare complication of fistulizing Crohn's disease.
磁共振成像综合诊断：肛瘘型克罗恩病罕见并发症——骨与多部位肌脓肿
J Crohns Colitis. 2011 Oct;5(5):473-6. doi: 10.1016/j.crohns.2011.04.009. Epub 2011 May 14.
4
Musculoskeletal complications of Crohn's disease: the role of computed tomography in diagnosis and patient management.克罗恩病的肌肉骨骼并发症：计算机断层扫描在诊断及患者管理中的作用
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Transrectal sonographically guided drainage of deep pelvic abscesses.经直肠超声引导下深部盆腔脓肿引流术。
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Osteomyelitis of the sacrum as the initial manifestation of Crohn's disease.
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